11 July 1997

Key elements of research into end-of-life decision-making conducted by University of Queensland academics have contributed to the Queensland Government's new Powers of Attorney Bill.

Dr Margaret Steinberg and co-researcher Colleen Cartwright approached the State Government with results of three years research to help formulate documentation to accompany the bill, which was recently launched for public discussion.

Dr Steinberg is the director, and Ms Cartwright a senior research officer, in the Healthy Ageing Research Unit in the Social and Preventive Medicine Department.

The closing date for public comment was July 11, and the new laws are expected to be operational by September.

'It is gratifying that the results of our research have been incorporated into the design of these documents,' said Ms Cartwright.

Dr Steinberg said the inclusion of the research had 'as much impact on the lives of Queenslanders as any number of journal articles we may get published'.

The Healthy Ageing Unit gathered documents relating to the issue of substitute decision-making from around the world, selecting the best parts of 36 documents in use in other countries as the basis for documents used by the State Government.

Dr Steinberg is a member of the Intellectually Disabled Citizens Council of Queensland, which specialises in decision-making incapacity. It has some functions similar to Guardianship Boards in other states.

The Powers of Attorney Bill 1997 covers general power of attorney, enduring powers of attorney for financial and property matters, enduring powers of attorney for personal care and health care, and will also establish the Office of Adult Guardian.

The Advance Health Directive within the bill is 'almost entirely' the same as developed by the Healthy Ageing Research Unit, Dr Steinberg said.

'Our work gave the government the confidence that a great deal of consultation with community and professional members had already taken place,' she said.

'We had undertaken the work with rigour, testing it out with Queenslanders and refining it over and over again. The presented data is a major piece of research. '

Their first 18-month study of 1100 community members and over 1200 health professionals found that 60 percent of community members said a written document expressing their wishes for a time when they would be incapable of making decisions was important to them.

Seventy-six percent of both community members and health professionals said advance directives would make a useful contribution to medical care. Sixty-nine percent of community members also said they believed they should be allowed by law to appoint someone to make their medical decisions in case they were not able to do so.

However, only 47 percent said they would ever think about making an Advance Health Directive or 'living will' - most because they did not know enough about them or how to do so.

Dr Steinberg said health professionals surveyed also admitted they did not know enough about issues of Advance Health Directives, including their legal status.

'We would like to see this being discussed more between general practitioners and their patients,' she said.

'People over 70 who need to have a doctor's certificate to renew their driver's licence could discuss Advance Health Directives with their doctor, and then review it every year.

'We need to encourage more doctor/patient communication and discussion among families over these issues.'

Team members conducting the research were Dr Steinberg, Ms Cartwright, Professor Jake Najman, Dr Malcolm Parker, Associate Professor Gail Williams, Sir Raymond Hoffenberg and Professor Chris Del Mar.

For more information please contact Dr Steinberg on (07) 3365 5424 or Ms Cartwright on (07) 3365 5328.